Workplace Gossip Complaint Form
Report workplace gossip incidents, identify who was involved, describe what happened, and share any witnesses or impact so the issue can be reviewed.
Reporter Information
Full Name
*
First Name
Last Name
Job Title / Department
*
Work Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Incident Details
Date of Incident
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Approximate Time
Hour Minutes
AM
PM
AM/PM Option
Location/Setting
*
Please Select
Office
Break Room
Meeting
Email
Chat App
Phone Call
Virtual Meeting
Other
Description of What Was Said or Done
*
People Involved and Witnesses
People believed to be involved
*
Witnesses
Type of knowledge
*
Direct evidence
Firsthand knowledge
Secondhand knowledge
Impact and Follow-up
How did this incident affect you or the workplace?
*
Stress or anxiety
Reputational harm
Team conflict
Reduced productivity
Difficulty collaborating
Other
Has this issue been reported before?
*
Yes
No
Unsure
Additional details or supporting context
Submit Complaint
Should be Empty: